retrospective agreement and consent to neurocritical care is influenced by functional outcome回顾协议,同意neurocritical保健功能影响的结果.pdfVIP

Kiphuth et al. Critical Care 2010, 14:R144 /content/14/4/R144 RESEARCH Open Access Retrospective agreement and consent to neurocritical care is influenced by functional outcome * Ines C Kiphuth , Martin Köhrmann, Joji B Kuramatsu, Christoph Mauer, Lorenz Breuer, Peter D Schellinger, Stefan Schwab, Hagen B Huttner Abstract Introduction: Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care–given by patients or their relatives–depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care. Methods: We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent. Results: High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent. Conclusions: Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected